Ezetimibe In Addition To Atorvastatin Therapy On The Plaque Composition In Patients With Acute Myocardial Infarction. (OCTIVUS)
1 de setembro de 2014 atualizado por: Mikkel Hougaard, Odense University Hospital
The Effect Of Ezetimibe In Addition To Optimal Cholesterol-Lowering Statin Therapy On The Plaque Composition In Patients With Acute Myocardial Infarction - Assessed By Optical Coherence Tomography And Intravascular Ultrasound.
The purpose of the study is to examine the effect of the cholesterol lowering agent Ezetimibe when used in addition to optimal treatment with Atorvastatin in patients with acute ST-Elevation Myocardial Infarction (STEMI) who have not been in prior statin therapy.
An area with arteriosclerosis not demanding intervention in a coronary vessel other than the infarct related is used as measuring point and is examined at time of the infarction and after 12 month using intravascular ultrasound and optical coherence tomography. At the same time the same techniques are used to examine the implanted stent.
Visão geral do estudo
Status
Concluído
Intervenção / Tratamento
Descrição detalhada
Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) with tissue characterization (IVUS-TC) are relatively new expansions to intravascular assessments, and has the capacity to assess plaque composition and, potentially, to identify vulnerable plaques. One of the mechanisms by which statins improve patient outcomes may be by changing the composition of a "vulnerable" plaque. The main effect is believed to rely on a lowering of LDL-c. The question is whether a further reduction of LDL by adding ezetimibe to optimal cholesterol lowering therapy using statins may result in further plaque stabilization or reduction. This is the hypothesis of the current study.
100 patients are randomized to Ezetimibe 10 mg per day or placebo. All patients are treated with Atorvastatin 80 mg. OCT and IVUS are performed at inclusion (typically the day after Primary PCI) and again at follow-up after 12 month.
Tipo de estudo
Intervencional
Inscrição (Real)
87
Estágio
- Fase 4
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
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Odense C, Dinamarca, 5000
- Department of Cardiology, Odense University Hospital
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
18 anos a 81 anos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
Inclusion Criteria:
- ST segment elevation acute myocardial infarction
- 20% < angiographic diameter stenosis < 50% on a not previously revascularized native coronary artery
- Statin naïve
- In fertile women: Ongoing contraception with IUD or hormonal contraception.
Exclusion Criteria:
- Pharmacologic lipid lowering treatment before index hospitalization
- Atrial fibrillation, not well rate-controlled
- Ventricle frequency variation with more than a factor 2 over 1 minute
- Unconscious patients
- History of statin induced myopathy, or serious hypersensitivity reaction to other HMG-CoA reductase inhibitors (statins) including Atorvastatin.
- Pregnant women, women who are breast feeding, and women of childbearing potential who are not using chemical or mechanical contraception or have a positive serum pregnancy test (a serum-human chorionic gonadotrophin [Beta-HCG] analysis)
- History of malignancy (unless a documented disease free period exceeding 5-years is present) with the exception of basal cell or squamous cell carcinoma of the skin. Women with a history of cervical dysplasia would be permitted to enter the study provided they had 3 consecutive clear Papanicolaou (Pap) smears
- Uncontrolled hypothyroidism (TSH > 1.5xULN)
- Abnormal LFT's
- History of alcohol or drug abuse within the last 5 years (this may affect compliance)
- Current active liver disease (ALT/SGPT >2xULN or severe hepatic impairment (to protect patient safety as directed on the labels of currently approved statins)
- Unexplained creatine kinase (CK > 3xULN) (To protect patient safety) (will be increased at baseline because of acute ST segment elevation myocardial infarction a few days before enrolment)
- Serum creatinine >176mmol/L (2.0mg/dL) (unless the protocol specifically aims to investigate a chronic renal disease population)
- Participation in another investigational drug study less than 4 weeks before enrolment in the study, or according to subjects local ethics committee requirements where a larger period is stipulated (to avoid potential misinterpretation of overlapping adverse events)
- Treatments with cyclosporine
- Treatment with gemfibrozil
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Diagnóstico
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Comparador de Placebo: Atorvastatin plus Placebo
50/100 patients are randomized to Atorvastatin 80 mg per day plus placebo.
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100 patients with ST elevation myocardial infarction are randomized 1:1 to either placebo or Ezetimibe 10 mg per day in addition to treatment with Atorvastatin 80 mg in both arms.
Outros nomes:
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Experimental: Atorvastatin plus Ezetimibe
100 patients with ST elevation myocardial infarction are randomized 1:1 to either placebo or Ezetimibe 10 mg per day in addition to treatment with Atorvastatin 80 mg in both arms.
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100 patients with ST elevation myocardial infarction are randomized 1:1 to either placebo or Ezetimibe 10 mg per day in addition to treatment with Atorvastatin 80 mg in both arms.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Plaque volume and composition in a non-significant coronary plaque
Prazo: After 12 months of follow-up
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Plaque volume assessed by intravascular ultrasound and Optical Coherence Tomography
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After 12 months of follow-up
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Medidas de resultados secundários
Medida de resultado |
Prazo |
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Change in plaque-composition (measured with Tissue Characterization) in a 10 mm segment of a native coronary vessel with a non-significant stenosis where plaque-volume at baseline is greatest.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Change in percent of the plaque volume in the native coronary vessel with a non-significant stenosis.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Change in percent of the plaque volume in the 10 mm segment of a native coronary vessel with a non-significant lesion where plaque volume at baseline is greatest.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Change in absolute numbers of the plaque volume in the 10 mm segment of a native coronary vessel with a non-significant lesion where plaque volume at baseline is greatest.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Change in percent of the plaque burden in the 10 mm segment of a native coronary vessel with a non-significant lesion where plaque volume at baseline is greatest.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Change in percent of the plaque burden in a native coronary vessel with a non-significant lesion.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Incomplete stent apposition.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Edge response in stented segment.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Stent expansion.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Evaluation of the OCT-technique in clinical use compared to IVUS.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Evaluation of the Resolute stents effect on neointima growth and apposition.
Prazo: After 12 months of follow-up
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After 12 months of follow-up
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Investigador principal: Mikkel Hougaard, MD, Department of Cardiology, Odense University Hospital
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo
1 de junho de 2011
Conclusão Primária (Real)
1 de junho de 2014
Conclusão do estudo (Real)
1 de setembro de 2014
Datas de inscrição no estudo
Enviado pela primeira vez
28 de junho de 2011
Enviado pela primeira vez que atendeu aos critérios de CQ
29 de junho de 2011
Primeira postagem (Estimativa)
30 de junho de 2011
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
3 de setembro de 2014
Última atualização enviada que atendeu aos critérios de controle de qualidade
1 de setembro de 2014
Última verificação
1 de setembro de 2014
Mais Informações
Termos relacionados a este estudo
Palavras-chave
- OUTUBRO
- Tomografia de coerência óptica
- Teste aleatório
- Inibidores Enzimáticos
- Atorvastatina
- IVUS
- Ações Farmacológicas
- Usos terapêuticos
- Ezetimiba
- Ultrassom intravascular
- Inibidores da hidroximetilglutaril-CoA redutase
- Mecanismos Moleculares de Ação Farmacológica
- Infarto do Miocárdio com Elevação do Segmento ST
- Agentes Hipolipidêmicos
- Agentes Reguladores Lipídicos
Termos MeSH relevantes adicionais
- Isquemia
- Processos Patológicos
- Necrose
- Isquemia do miocárdio
- Doenças cardíacas
- Doenças cardiovasculares
- Doenças Vasculares
- Infarto do miocárdio
- Infarte
- Infarto do Miocárdio com Elevação do ST
- Mecanismos Moleculares de Ação Farmacológica
- Antimetabólitos
- Agentes Anticolesterêmicos
- Agentes Hipolipidêmicos
- Agentes Reguladores Lipídicos
- Ezetimiba
Outros números de identificação do estudo
- OUH-OCTIVUS
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